Risk factors for blood transfusion in traumatic and postpartum hemorrhage patients: Analysis of the CRASH-2 and WOMAN trials

Kolin, David A.; Shakur-Still, Haleema; Bello, Adenike; Chaudhri, Rizwana; Bates, Imelda; Roberts, Ian

doi:10.1371/journal.pone.0233274

Cited by 13 publications

(5 citation statements)

References 42 publications

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“…Cesarean section is associated with an increased risk of significant intra-operative blood loss; hence, women undergoing Cesarean sections are at increased risk for administering blood products in obstetric emergencies (20). In agreement with our study results, a multinational, randomized trial of 20,060 women with postpartum hemorrhage conducted in 193 hospitals in 21 countries found that cesarean section and the presence of identifiable causes of bleeding significantly increased blood transfusion likelihood in the study population (21). Accordingly, a retrospective cohort study carried out in China found that factors such as polyembryony, placental and uterine complications (including placental implantation abnormalities, placenta previa, retained placenta, intrauterine adhesions, and uterine rupture), stillbirth, and HELLP syndrome significantly increased the probability of perinatal blood transfusion (22).…”

Section: Discussionsupporting

confidence: 89%

Blood Transfusion and Associated Factors in Pregnant Women Admitted to a Tertiary Care Hospital in Southeast Iran

et al. 2023

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Background: Effective blood transfusion is a life-saving practice in obstetrics and gynecology emergencies that can prevent blood product wastage in hospitals. Objectives: This study was performed to evaluate the appropriateness of the use of blood products in pregnant women in a tertiary care hospital in Zahedan, southeast Iran. Methods: This cross-sectional study was carried out from September 2019 to March 2020 to assess the patterns of blood utilization in a tertiary care hospital in Zahedan, Iran. Blood bank registries and the data of 1,500 pregnant women were used for data analysis, using blood transfusion indices, including cross-matched to transfusion (C/T) ratio, transfusion probability (T), and transfusion index (TI). Results: Out of 1,064 units of requested blood products, 581 (54.6%) were cross-matched, and 774 (72.7%) were transfused to patients. The blood transfusion indices of C/T, T%, and TI were 2.11, 48.48%, and 0.76, respectively. The transfusion rate was 6.2%, and the commonest associated obstetrics complication requiring transfusion was uterine atony (32.2%), followed by anemia (17.2%). There was a statistically significant relationship between the type of delivery, uterine and placental problems, coagulation disorders during pregnancy, number of deliveries, and residence place, and the probability of blood transfusion (P > 0.05). Conclusions: The overall blood utilization indices were encouraging; however, the proportion of blood wastage was relatively high. Regular auditing is needed to optimize the use of blood and blood products in obstetrics and gynecology departments.

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Section: Discussionsupporting

confidence: 89%

Blood Transfusion and Associated Factors in Pregnant Women Admitted to a Tertiary Care Hospital in Southeast Iran

et al. 2023

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“…15 Clinical contexts associated with blood transfusion have been recently explored in a secondary cohort analysis of data extracted from the WOMAN trial, an international randomized trial studying the efficiency of tranexamic acid on blood loss from obstetric hemorrhage. 16 In this analysis, delivery outside the hospital (ARR 1.30 95%CI 1.22-1.39), delivery more than 3 hours before hospitalization (ARR 1.09 95%CI 1.01-1.17), cesarean section (ARR 1.16 95%CI 1.08-1.25), and obstetric hemorrhage from other causes than uterine atony significantly increased the risk of blood transfusion.…”

Section: Risk Factors For Blood Transfusion In Obstetric Hemorrhagementioning

confidence: 74%

When and how should I transfuse during obstetric hemorrhage?

Waters

Bonnet

2021

International Journal of Obstetric Anesthesia

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“…A meta‐analysis of eight studies showed a lower incidence of PPH >1000 mL among women with a CS without medical indication, but no difference in the blood transfusion rate 41 . Other studies described higher incidences of blood transfusion 42,43 . Most studies did not stratify by parity.…”

Section: Discussionmentioning

confidence: 99%

“…41 Other studies described higher incidences of blood transfusion. 42,43 Most studies did not stratify by parity. Our results showed a lower incidence of PPH after CS among nulliparous women, but a higher incidence among multiparous women.…”

Section: Interpretation and Further Researchmentioning

confidence: 99%

Trends in postpartum hemorrhage and manual removal of the placenta and the association with childbirth interventions: A Dutch nationwide cohort study

Seijmonsbergen‐Schermers,

Rooswinkel,

Peters

et al. 2023

Birth

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BackgroundBecause the cause of increasing rates of postpartum hemorrhage (PPH) and manual placental removal (MROP) is still unknown, we described trends in PPH, MROP, and childbirth interventions and examined factors associated with changes in rates of PPH and MROP.MethodsThis nationwide cohort study used national perinatal registry data from 2000 to 2014 (n = 2,332,005). We included births of women who gave birth to a term singleton child in obstetrician‐led care or midwife‐led care. Multivariable logistic regression analyses were used to examine associations between characteristics and interventions, and PPH ≥ 1000 mL and MROP.ResultsPPH rates increased from 4.3% to 6.6% in obstetrician‐led care and from 2.5% to 4.8% in midwife‐led care. MROP rates increased from 2.4% to 3.4% and from 1.0% to 1.4%, respectively. A rising trend was found for rates of induction and augmentation of labor, pain medication, and cesarean section, while rates of episiotomy and assisted vaginal birth declined. Adjustments for characteristics and childbirth interventions did not result in large changes in the trends of PPH and MROP. After adjustments for childbirth interventions, in obstetrician‐led care, the odds ratio (OR) of PPH in 2014 compared with the reference year 2000 changed from 1.66 (95% CI 1.57–1.76) to 1.64 (1.55–1.73) among nulliparous women and from 1.56 (1.47–1.66) to 1.52 (1.44–1.62) among multiparous women. For MROP, the ORs changed from 1.51 (1.38–1.64) to 1.36 (1.25–1.49) and from 1.56 (1.42–1.71) to 1.45 (1.33–1.59), respectively.ConclusionsRising PPH trends were not associated with changes in population characteristics and rising childbirth intervention rates. The rising MROP was to some extent associated with rising intervention rates.

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Risk factors for blood transfusion in traumatic and postpartum hemorrhage patients: Analysis of the CRASH-2 and WOMAN trials

Cited by 13 publications

References 42 publications

Blood Transfusion and Associated Factors in Pregnant Women Admitted to a Tertiary Care Hospital in Southeast Iran

Blood Transfusion and Associated Factors in Pregnant Women Admitted to a Tertiary Care Hospital in Southeast Iran

When and how should I transfuse during obstetric hemorrhage?

Trends in postpartum hemorrhage and manual removal of the placenta and the association with childbirth interventions: A Dutch nationwide cohort study

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